Investigating the Change in Anthropometric and MFBIA Measurements Pre- and Post- Dialysis and the Impact of Arteriovenous Vascular Fistula on Muscle Strength and the Prevalence of Sarcopenia in Haemodialysis Patients Using Different Measurements and Find the Correlation Between Them.

Abstract

Background: sarcopenia is a major issue that effect haemodialysis (HD) patients regardless of their age, and early detection is necessary to reverse and treat it. However, the tools to be used to detect sarcopenia are affected with over-hydration and arteriovenous vascular fistula (AVF) presents and lead to over or under-estimate muscle mass and strength. Moreover, there are variety of tools to assess sarcopenia. Objectives: to investigate (1) the prevalence of sarcopenia in haemodialysis patients using the SARC-F questionnaire, anthropometric measurements and Multifrequency bioelectrical impedance analysis (MFBIA) (2) the difference of the measurements pre- and post-dialysis treatment (3) the impact of AVF on muscle mass and muscle strength in the arm (4) the relationship between the measurements to assess sarcopenia. Methods: an observational study was conducted on 144 participants recruited from three dialysis unites in London under care of Royal Free Hospital, United Kingdom (UK). A SARC- F questionnaire, anthropometric measurement includes (triceps skinfold thickness, mid-ram circumference, handgrip and pinch strength) and MFBIA were performed. Mid-arm muscle circumference (MAMC), appendicular lean mass index (ALMI) and skeletal muscle index (SMI) was calculated 2 Result: prevalence of sarcopenia varies based on the tools. Handgrip strength (HGS) detected the highest percentage of sarcopenia 97%, 98% in males and females respectively. HGS associated with all of measurement except MAMC, with SARC-F r = -0.52, SMI r = 0.52, and ALMI r = 0.50. MAMC has lower or no correlation with the measurements. SMM and ALMI have significantly decreased post-dialysis P<0.001. MAMC is significantly decrease post- dialysis in AVF and non-AVF arm p= 0.003, p= 0.02 respectively. HGS and pinch strength were declined in AVF hand, p<.001. Conclusions: muscle mass is over-estimated pre-dialysis. AVF has a negative impact on muscle strength in HD. Prevalence of sarcopenia is vary according to the tools, however, MAMC detect a lower percentage of sarcopenia. Handgrip strength (HGS) has a correlation with appendicular lean mass index (ALMI), skeletal muscle index (SMI), and SARC-F questionnaire.